- Humana (Austin, TX)
- …a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and… more
- Robert Half Office Team (Monterey Park, CA)
- Description The Utilization Management Nurse Specialist LVN promotes the quality and cost effectiveness of medical care by applying clinical acumen and the ... on case findings. Functions & Job Responsibilities * The Utilization Management Nurse Specialist LVN will facilitate,...for admissions in any inpatient setting * May performs telephonic and/or on-site admission and concurrent review ,… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II will...Actively monitors for admissions in any inpatient setting. Performs telephonic and/or on site admission and concurrent review… more
- CVS Health (Raleigh, NC)
- …Suite (PowerPoint, Word, Excel, Outlook) Preferred Qualifications - 1+ years' experience Utilization Review experience - 1+ years' experience Managed Care - ... make health care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is...Strong telephonic communication skills - Experience with computers toggling between… more
- CVS Health (Columbus, OH)
- …4:30pm in time zone of residence. Preferred Qualifications: -1+ years' experience Utilization Review experience -1+ years' experience Managed Care - Strong ... care more personal, convenient and affordable. Position Summary: This Utilization Management (UM) Nurse Consultant role is... telephonic communication skills -1+ years' experience with Microsoft Office… more
- CVS Health (Columbus, OH)
- …department (typically 1 holiday per year). Preferred Qualifications: - 1+ years' experience Utilization Review experience - 1+ years' experience Managed Care - ... care more personal, convenient and affordable. Position Summary: This Utilization Management (UM) Nurse Consultant role is...Strong telephonic communication skills - 1+ years' experience with Microsoft… more
- CVS Health (Austin, TX)
- …per business needs Preferred Qualifications - Managed Care experience preferred - Utilization Review experience preferred - Ability to navigate multiple computer ... to make health care more personal, convenient and affordable. Position Summary This Utilization Management (UM) Nurse Consultant role is fully remote and… more
- Adecco US, Inc. (Dallas, TX)
- **Join Our Team as a Utilization Management Nurse !** **Experience Required:** + Five years inpatient clinical nursing experience in an acute care hospital ... Provide precertification of inpatient hospitalizations and outpatient procedures + Conduct telephonic and/or concurrent review of inpatient hospitalizations and… more
- Universal Health Services (Conway, SC)
- …Job Posting Lighthouse Behavioral Health Hospital is hiring for a Part Time RN Utilization Review Coordinator. Utilization Review / Risk Management ... UHS and its 300+ Subsidiaries! Flexible Schedule Qualifications Job Requirements The Utilization Review Coordinator position will consist of Four 8-hour Daylight… more
- Adecco US, Inc. (Dallas, TX)
- …clinical nursing experience in an acute care hospital setting, minimum of 2 years Utilization Management/ Review in an acute care setting, Minimum of 2 yeras ... very close knit team and being a team player is a must! The Utilization Management Nurse will provide precertification of inpatient hospitalizations and all… more
- US Tech Solutions (Columbia, SC)
- …Knowledge of National Committee for Quality Assurance (NCAG). Knowledge of Utilization Review Accreditation Commission (URAC). Knowledge of South Carolina ... of Nursing. Required Work Experience: 2 years clinical experience plus 1 year utilization /medical review , quality assurance, or home health, OR, 3 years… more
- Health Advocates Network (Harrisburg, PA)
- …setting, behavioral health setting, drug and alcohol setting, managed care, quality management/ utilization review or other related clinical experience; or An ... R&E Nurse - Med Care Services- Advanced **Pay Rate:** $27...(MA), health care services, human services, long term care, utilization review , or knowledge of home care… more
- Nuvance Health (Poughkeepsie, NY)
- …or BSN preferred. Must have current RN license. Preferred experience in Utilization Review /Management. Location: Vassar Brothers Medical Center Work Type: Per ... Nurse Case Manager - Per Diem Location: Poughkeepsie,...physiological and economic perspectives. Has overall accountability for the utilization management and transition management for patients within the… more
- ERP International (Luke AFB, AZ)
- …Case Management Society of America (CMSA); American Accreditation Healthcare Commission/ Utilization Review Accreditation Commission (URAC); CAMH; (AAAHC); Health ... **Overview** ERP International is seeking full time **Registered Nurse - Case Management** in support of the56th Medical Group at Luke AFB, AZ… more
- The Cigna Group (Mobile, AL)
- …skills + Typing and computer knowledge- able to type 35WPM + Knowledge of utilization review requirements and procedures + Knowledge of current health care ... and metrics for customers and communicates to provider + Review STAR summary gap report (daily) by payor +...include primary care physician and specialist appointment scheduling + Nurse notifies PCP daily of admissions and discharges +… more
- NJM Insurance (Trenton, NJ)
- …Workers' Compensation line of business by performing prospective and retrospective Utilization Review of pharmaceutical/medication requests in accordance with ... and causally related. + Evaluate requests that are routed for clinical review based upon established criteria to issue appropriate and timely determinations on… more
- Centers Plan for Healthy Living (Bronx, NY)
- Nurse Practitioner - ISNP (Full-Time & Part-Time) Bronx, NY, USA Req #8 Monday, April 29, 2024 Our NP CHAMPIONS advocate to i mprove the health and quality of life ... plans they need for healthy living. JOB SUMMARY: The nurse practitioner treats acute and chronic conditions in place...Identify, treat, and document changes in condition + Order, review and/or follow-up with treatments and diagnostic testing +… more
- Centers Plan for Healthy Living (Brooklyn, NY)
- Nurse Practitioner - ISNP (Full-Time) Brooklyn, NY, USA Req #363 Monday, April 29, 2024 Centers Plan for Healthy Living's goal is to create the ultimate healthcare ... plans they need for healthy living. JOB SUMMARY: The nurse practitioner treats acute and chronic conditions in place...Identify, treat, and document changes in condition + Order, review and/or follow-up with treatments and diagnostic testing +… more
- Albany Medical Center (Albany, NY)
- …Shift: Day (United States of America) Salary range: $68,640 - $99,023 Registered Nurse General Pediatrics Office Work schedule: Monday - Friday 8:00am - 4:30pm (with ... the practice physician and/or advanced practice provider (APP) and the supervision of the Nurse Manager (RN) and/or Nurse Supervisor (RN), the RN may provide… more
- The Cigna Group (Harlingen, TX)
- …skills * Typing and computer knowledge- able to type 35WPM * Knowledge of utilization review requirements and procedures * Knowledge of current health care ... participate in weekly Complete Health Team rounds * Perform telephonic outreach or home visits, as needed * Communicates...* None **Experience:** * Current Licensure as a Registered Nurse , in the state of Texas in good standing.… more
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